Tumor Seeding after Fine Needle Aspiration Biopsy and Percutaneous Radiofrequency Thermal Ablation of Hepatocellular Carcinoma

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Abstract
Background: Radiofrequency thermal ablation (RFTA) has become a popular method of unresectable liver tumor ablation. However, its side effects should be paid attention to. Case Report: A 76-year-old woman was found with an 8.4 × 6.9 cm subcapsular mass in the left lateral liver lobe. She had cirrhosis with active hepatitis C. Well-differentiated hepatocellular carcinoma (HCC) was diagnosed based on fine needle aspiration biopsy (FNAB) of the liver mass. Later she was treated with ultrasound-guided percutaneous RFTA using an expandable-type electrode. Contrast-enhanced computer tomography (CT) suggested that the necrosis of the tumor was complete. Every 3 months, she had a follow-up, consisting of clinical and abdominal CT examinations. One year after treatment, a 3-cm soft tissue mass was found in the upper abdominal wall. The mass was resected and it was diagnosed as metastatic HCC. Conclusion: This case indicated that percutaneous RFTA was effective in local control of large HCC. However, the diagnostic FNAB, or percutaneous RFTA itself, may result in needle-track tumor seeding.